Provider Demographics
NPI:1750312831
Name:WALKER, DENA (CNM)
Entity Type:Individual
Prefix:MRS
First Name:DENA
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2816 WILLOW WAY
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-5164
Mailing Address - Country:US
Mailing Address - Phone:801-472-5404
Mailing Address - Fax:801-472-5404
Practice Address - Street 1:50 N MEDICAL DR
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132-0001
Practice Address - Country:US
Practice Address - Phone:801-587-9500
Practice Address - Fax:801-585-2108
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6171834-4402367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX420001841OtherRAILROAD MEDICARE
TX8N3726OtherBCBS
TX156793501Medicaid
TX156793501Medicaid
TX8A4581Medicare ID - Type Unspecified